BATON ROUGE -- In his 30 years as Orleans Parish criminal sheriff, Louisiana Attorney General Charles Foti endured plenty of moments in the local limelight. But he stepped on the world stage of news events Tuesday when he announced the arrest of a doctor and two nurses for allegedly administering lethal doses of painkillers to four patients at Memorial Medical Center on the third day after Hurricane Katrina.

CNN broke from its coverage of the Lebanon crisis to carry the live report from Foti's news conference, telling a story that served as a grim reminder of the misery caused by Katrina combined with the emotionally charged issue of mercy killings.

"To me, it was done to have a national and international effect, to take a bow for the investigation, " said Rick Simmons, the attorney for the accused Dr. Anna Maria Pou. "My client's presumption of innocence was trampled on."

As a statewide elected official, Foti now faces the inevitable skepticism about his political motivations and handling of a high-profile case. His office maintains that it has strong evidence, has followed the right procedures, and has gone out of its way to avoid exposing the accused to unnecessary media attention.

Given the compelling facts uncovered by the attorney general's Medicaid Fraud Control Unit, Foti would have been accused of corruption and favoritism on a grand scale had he not proceeded to make the arrests, said Foti's spokeswoman, Kris Wartelle. His critics would have been legion, she said.

"They would have been screaming politics all over the place, " Wartelle said.

Comment in the past week on talk radio and in letters to the editor suggests that the reaction to Foti's probe cuts two ways. On one side, people are dismayed or angry at the idea of medical professionals making what they see as arbitrary decisions to end people's lives during the Katrina crisis. On the other side, there is disgust that a year after the storm, doctors and nurses who toughed it out in area hospitals are being accused by officials who, at every level of government, are seen to have poorly managed the disaster.

Pou and nurses Lori Budo and Cheri Landry, who are all accused of second-degree murder, were arrested in private Monday night, thereby avoiding the kind of photo and video coverage of suspects in handcuffs that often splash a big crime story. Foti wanted the arrests to be private, Wartelle said. A New Orleans judge subsequently released them on their own recognizance. Their attorneys have said the arrests were unnecessary, given that the women were prepared to surrender if charged.

They have not been formally charged with a crime. Under Louisiana laws of jurisdiction, it is now the responsibility of Orleans Parish District Attorney Eddie Jordan to decide how to proceed, and he has said his next step will be to ask a grand jury to look at the evidence. Jordan is not obligated to pursue second-degree murder charges, or he could charge the women with more serious or less serious crimes.

The chain of events this week has led to accusations that Foti was dumping the case on Jordan and walking away with the credit for cracking open a probe that may not have yielded enough hard evidence to result in convictions. But Foti says he has not washed his hands of the investigation or even of the prosecution.

If Jordan asks the attorney general to join the case, Foti's office has lawyers specialized in the field who will lend assistance, Wartelle said.

Still investigating

Foti's office is continuing to investigate deaths at Memorial, a major Uptown hospital that was mired in floodwater and without running water or electricity by the time staff and patients were evacuated three days after Katrina struck. More than 40 dead bodies were retrieved from the hospital, state health officials said.

According to an affidavit from the attorney general's office, the three accused women intentionally killed four patients by administering lethal doses of the depressants morphine sulphate and midazolam on Sept. 1, as an evacuation of the facility was mobilized. Those patients needed acute medical attention but were not terminally ill and could have been evacuated, Wartelle said. One of the patients was a 380-pound man who had already survived an evacuation to the hospital from a Chalmette (Katrina photos: The early days in St. Bernard) nursing home.

There were additional potential homicides at Memorial, and the investigation of those is ongoing, Wartelle said. "Dozens" of tissue samples from those dead show "mysterious levels" of drugs that should not have been in the patients' bodies, Wartelle said.

The affidavit says three medical professionals who were on the scene and claim that Pou said on Sept. 1 she was going to give lethal doses of drugs to some patients. The affidavit does not say whether those witnesses tried to stop Pou. It makes a case that Pou and the nurses had the opportunity and sought private quarters to carry out the injections with vials that were readily available. At the time, rescue teams were marshaling a full evacuation of the hospital that was sure to be stressful on sick patients. The dead were being left behind.

A story that ran Sept. 11 in the London Daily Mail quoted an unnamed female doctor in New Orleans admitting she injected morphine into patients who were dying and in agony in a hospital as it was being evacuated. "In some cases the drugs may have speeded up the death process, " the doctor was quoted as saying. "This was not murder, this was compassion. They would have been dead within hours, if not days."

Wartelle did not say whether the story would be used as evidence.

Simmons said his client would have surrendered herself to authorities and that the sudden arrests were unexpected and unnecessary. Foti could have coordinated the case with the district attorney beforehand to determine whether actual charges would be made, Simmons said.

Because Pou has been booked but not charged, Simmons must deal with a legal limbo while trying to develop a defense. He said Thursday he needs medical records in the case but might be denied access to them until charges are filed.

Lots of political clout

Even by Louisiana political standards, Foti is a colorful public personality, traipsing about the state for meetings and speeches with his trademark unlit cigar hanging from his perpetually smiling lips. He was the inspiration for a recently filmed pilot for a fictional television series called "The General."

Foti was a prosecutor for the city before becoming sheriff in 1973. He remade the sheriff's office and ruled its 7,000-inmate jail with a swagger that often caused controversy but never seemed to cost him much political capital.

Foti brought an unconventional style to the attorney general's office in 2004, creating a new employment application that even staff already on the payroll had to fill out. It contained questions about applicants' race, age, tattoos, scars and birthmarks that ruffled the government workers' feathers. Labor lawyers said the questions were not illegal but could have increased the agency's vulnerability to charges of job discrimination, and the application was changed.

Foti plans to run for re-election next year and had $971,724.32 in his campaign coffers at the end of 2005, according to his most recent campaign filing. At 68 he is admittedly hard of hearing, but he appears fit and moves with a quick step.

A Democrat with a large number of Republican admirers, Foti needs only to keep his pulse beating to win re-election, said Bernie Pinsonat, a pollster with Southern Media and Opinion Research.

"Nothing's a cinch, but he's the next best thing to it, " said Pinsonat, who doubted that a serious challenger would get into the race.

State Republican Party Chairman Roger Villere said he would favor a GOP member as attorney general, but Foti "seems to be doing a good job, " he said. The Memorial hospital investigation was "the right thing to do, " Villere said, but he urged Foti to avoid the appearance of a witch hunt and a negative image nationally for Louisiana.

Follow-through important

The hospital case could have a bearing on Foti's reputation in the long run. His office has been involved in a number of cases resulting in arrests for fraud, including bilking money from individuals or the public assistance system during the storm recovery. But since Katrina, Foti has built up a mountain of highly visible and as yet unfinished investigations, leaving him vulnerable to the accusation that he's all bark and no bite.

St. Bernard Parish gave him jurisdiction to prosecute St. Rita nursing homeowners in the deaths of residents who were not evacuated before Katrina. Foti hopes to convene a grand jury on the case in the "next few weeks, " Wartelle said.

The attorney general is conducting a larger investigation of 13 nursing homes and eight hospitals where deaths occurred related to Katrina. The Medicaid Fraud Control Unit has developed a case on one of those nursing homes, which Wartelle would not name. The case will soon be turned over to Jordan, she said.

Foti's consumer protection unit is investigating the Humane Society of the United States, a highly regarded animal-assistance group that helped finance and operate the huge pet-sheltering operation after Katrina, for possible misuse of private donations. The society said it has done nothing wrong and hopes the inquiry ends soon.

Among the more laggard investigations is Foti's long-awaited report on the Crescent City Connection incident, in which Gretna police stopped a crowd made up primarily of black New Orleanians from evacuating into Jefferson Parish after the storm. The attorney general jumped into the racially charged issue last fall but has yet to produce any conclusions. Foti is "preparing to give the result" of the report to Jordan, Wartelle said.

What about the corps?

It's the cases Foti is not pursuing that rile some critics. Mississippi's attorney general filed suit against insurance companies to compel them to pay for Katrina water damages that the insurers say are not covered, a problem plaguing property owners in Louisiana as well. But Foti has not done likewise on behalf of Louisiana policyholders.

Wartelle said the attorney general's office is "meeting on and considering" the insurance matters.

Louisiana political commentator and lawyer C.B. Forgotston said he wishes Foti would answer Jordan's complaints about the criminal justice workload in the city by helping the district attorney prosecute some of the criminals in New Orleans' jails. Most of all, Forgotston said, he would like to see Foti pursue a criminal case against the Army Corps of Engineers for its work on the levees that were breached during Katrina, flooding the city and St. Bernard Parish.

"If the general is really interested in pursuing the most heinous crimes committed after Aug. 29, 2005, he should look at the crimes committed against hundreds of innocent citizens by the U.S. Army Corps of Engineers, " said Forgotston, whose home was flooded. "While I welcome the general to the war, I would prefer that he arrive with the cavalry."

Wartelle said the attorney general's office is working with various teams of investigators to examine the levee faults.

The Memorial Medical Center case gives Foti a chance to show his crime-fighting stripes, Pinsonat said. That's an image that attorneys general in Louisiana like to project, especially because the predominant duties of the office are in reality more akin to those of a corporate lawyer, he said. In the long run, Foti's reputation may be defined by his handling of the post-storm investigations.

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Robert Travis Scott can be reached at rscott@timespicayune.com or (225) 342-4197.

CORRECTION / CLARIFICATION
TV pilot not filmed: A July 23 story about state Attorney General Charles Foti incorrectly reported the status of the TV pilot "The General." That is a working title for a television pilot that has not been filmed. (10/17/2006)